Serious Mental Illness Among Young People Who Inject Drugs: An Assessment of Injection Risks and Healthcare Use
Monica Adams, Catlainn Sionéan, Dita Broz, Rashunda Lewis, Cyprian Wejnert, NHBS Study Group, Pascale Wortley, Jeff Todd, Kimi Sato, Colin Flynn, Danielle German, Dawn Fukuda, Rose Doherty, Chris Wittke, Nikhil Prachand, Nanette Benbow, Antonio D. Jimenez, Jonathon Poe, Shane Sheu, Alicia Novoa, Alia Al‐Tayyib, Melanie Mattson, Vivian Griffin, Emily Higgins, Kathryn Macomber, Salma Khuwaja, Zaida Lopez, Paige Padgett, Ekow Kwa Sey, Yingbo Ma, Marlene LaLota, John-Mark Schacht, D.W. Forrest, Bridget J. Anderson, Anthony Romano, Lou C. Smith, William T. Robinson, Narquis Barak, Meagan Zarwell, Alan Neaigus, Kathleen H. Reilly, Barbara Bolden, Afework Wogayehu, Henry Godette, Kathleen A. Brady, Mark Shpaner, Jennifer Shinefeld, Lissa Bayang, Veronica Tovar-Moore, H. Fisher Raymond, Theresa Ick, Sandra Miranda De León, Yadira Rolón-Colón, Tom Jaenicke, Hanne Thiede, Richard D. Burt, Jenevieve Opoku, Irene Kuo, Winston E. Abara, Alexandra B. Balaji, Dita Broz, Jonathan Cook, Laura A. Cooley, Melissa Cribbin, Paul Denning, Kate Doyle, Teresa Finlayson, Kathy Hageman, Kristen L. Hess, Brooke Hoots, Wade Ivy, Binh Le, Rashunda Lewis, Stacey Mason, Lina Nerlander, Gabriela Paz‐Bailey, Taylor Robbins, Kathryn Salo, Catlainn Sionéan, Amanda Smith, Justin S. Smith, Michael W. Spiller, Cyprian Wejnert, Akilah Wise, Mingjing Xia
Abstract
BACKGROUND: Data on behavioral correlates of mental illness among young people who inject drugs (PWID) are limited. We examine injection risks and healthcare use among young PWID with probable serious mental illness (PSMI). METHODS: People who inject drugs were recruited and interviewed in 20 US cities for 2015 National HIV Behavioral Surveillance. Probable serious mental illness was assessed using the Kessler-6 screening scale. Bivariate analyses using log-linked Poisson regression with generalized estimating equations adjusted for design covariates were conducted to examine associations between PSMI and behaviors among PWID ages 18-29 years. RESULTS: Of 1769 young PWID, 45% had PSMI. Compared to those without PSMI, PWID with PSMI were more likely to report injecting more than once a day, receptive syringe sharing, sharing of other injection equipment, and unmet needs for medical care and substance use disorder (SUD) treatment. Those with PSMI were less likely to use syringe services programs than those without PSMI. CONCLUSIONS: Approximately half of young PWID had PSMI. People who inject drugs with PSMI engaged in high-risk injection behaviors and encountered barriers to healthcare. Human immunodeficiency virus prevention programs such as Syringe Services Programs (SSPs) could benefit from screening for mental illness among young PWID and strong linkage to healthcare, including mental health and SUD treatment.